After significant advances in controlling the wet form of age-related macular degeneration (AMD), thanks to injections of intraocular antiangiogenic drugs, efforts are currently focused on trying to stop the advance of dry or atrophic AMD – the most prevalent form of the disease (85% of cases) – which currently has no treatment. With this aim, IMO is one of 300 research centres that are part of a European project promoted by Roche to assess the response of patients to a new drug (lampalizumab). This is the first therapy that has shown significant effectiveness in reducing the progression of dry AMD and is currently being tested in a phase III clinical trial – the last before going on sale. As explained by Dra. Anniken Burés, a specialist in IMO’s Department of Retina and Vitreous “what we are now trying to do is confirm the good results demonstrated in phase II, which slowed the disease by up to 40% in a particular group of patients. In this regard, the ophthalmologist added that “the new drug is effective in advanced stages of the disease and in people with a specific genetic profile.” This shows “that genetics is much more significant in AMD than we previously believed and, because of this, the future treatment of this and other retinal diseases will need to include genetic studies of patients and individualised therapies according to each profile”, as Dr Burés explains. Also currently being developed within this same line of research is Bioimage, a pioneering trial led by the IMO Foundation whose aim is to determine whether genotype (the information contained in DNA) affects responses to treatment, in this case, wet AMD.
How does lampalizumab work?
While treatment of wet AMD is based on preventing the proliferation of new abnormal blood vessels that bleed and leak fluid, lampalizumab works by inhibiting the inflammation pathways that play a key role in the progression of dry AMD. The aim is not for the patient to gain vision; it is to slow the progression of the disease, whose speed increases exponentially in the most severe stages. The fact that the effects of this type of AMD do not appear immediately hinders patient recruitment – the phase in which IMO finds itself at the moment in the study and which involves the administering of intravitreal injections of the new drug every 4 or 6 weeks for a period of two years. Dr Bures points out that “trial participants need to be aware that not everyone will benefit from the treatment, although this should not be the only objective. What we are seeking is not only individual short term improvement, but also long-term collective improvement, since concluding the study is the first essential step towards making the drug available and helping other people with the disease.” AMD (age-related macular degeneration) is the leading cause of global blindness among people over 65 and, in Spain alone, it affects 800,000 patients. Because of the progressive increase in life expectancy, the World Health Organization (WHO) estimates that, in the coming decades, the prevalence of this disease could triple, which is why it is considered one of the most serious social-healthcare problems of the century.